The prestige of embryology enjoyed by those who entered new field close to its inception and which we were taking for granted has diminished considerably over the last 20 years.
This is because we were focused on the science of embryology and did not make any efforts to regulate our own field. Even though we, "older generation", continue to retain respect as individuals, there are no questions that diminished respect for "embryology" as a specialty drags down every embryologist.
It is noteworthy, that “embryologist” is notoriously absent from ASRM mission statement or registration options. Instead, we have to register as "laboratory scientists", which is almost an insult to those filling intellectual capacity, because "laboratory scientists" has been borrowed from the diagnostic testing and refers squarely to "lab tech".
Diagnostic testing is the least respected part of medicine and embryology is not belong there anyway. This newsletter, which contains a link to ACE comments on DPH ruling represents a consensus document, vetted by board and advisory board and in many ways represent a program document of ACE http://embcol.org/node/146.
Our collective failure is the failure to “hatch” from the scientific mind-set and realize that there are other aspects of our new reality as embryology practitioners that we had to face.
I like citing this quote from Robert P. Buckwald, MD (president of NY State Society of Pathologists):
"My career has allowed me to work closely with many distinguished pathologists all of whom realized that, as a group and as individuals, we must participate in the molding, shaping and direction of our profession. Herb Lansky, Paul Bachner, Sheldon Taubman and David Tiersten taught me the nonscientific aspects of pathology, the economics and the politics. They correctly believed that if we didn't become involved and guide the profession, non pathologists would very willingly take over completely."
We know this for the fact, because just by virtue of its appearance ACE made a considerable impact on the position of embryologists within ASRM.
ACE, an organization of just a couple of people, was noticed and asked to be an amicus along side of an American Medical Association in a patent lawsuit pending before the supreme court.
While the prestige of embryology has greatly diminished over the years, its role, central to IVF, did not change, and our work continues to generate about 2/3 of IVF income, but our visibility has been reduced to a very low level.
ACE is the only organization in a position to serve as a flagship for elevating the prestige of embryology practitioners around the world.
ACE strategic goal: “To become an officially recognized organization through which embryology practitioners self-regulate all aspects of their education, training and practice.”
Due to the small number of people practicing embryology, it is my opinion that it is virtually impossible for our field to reach our goals using only our own resources.
We have to reach out to the public, which has vested interest in strong and ethical embryology.
Such members of public include those interested in embryology ethics and infertility patients.
There are following steps, that in my opinion are necessary to accomplish ACE strategic objectives:
1. Delineating clinical emrbyology
Our lines of authority and responsibility are very vague. There is no single embryologist in the youtube videos talking about PGD, embryo biopsy, ICSI etc. This is one of the direct results of the failure of embryologist to delineate their own field. Since it is not delineated, it makes it impossible say where embryology begins or ends. This leaves embryology practitioners unprotected and vulnerable to liability on one hand, while allowing anyone taking picture with the inverted microscope to claim an authority over embryology. This applies to both, technical and intellectual aspects of our work, although later is vaguer by far. We don’t know hat can we talk to the patient about, which decisions can we make for the patient.
Thus, ACE needs to define (delineate) embryology and keep the definition current. It has to be publicly available on the web site
We need to keep drawing a clear line between diagnostic testing and practice of medicine on one hand and embryology practice on another hand and claim it as exclusively our territory. We need to start with what is our without any questions and expand it into the areas, which are less obvious.
2. Education and training
We need to create a real, tangible barrier to be considered embryology expert. When we go to see a doctor, we know that whenever she received her degree, there is a major overlap in standardized portion of her training with other doctors. Doctors speak to each other in the same language. Embryologists have virtually no overlap in their education or/and training. They do not speak the same language.
We need to build an actionable knowledge base for our field that would become a reference point and the benchmark for every Doctor of Embryology to attain before being able to claim that he or she is an expert.
The knowledge is out there. But we need to take an initiative on reviewing and putting together the curriculum and syllabus that would be the state of the art.
ACE can solicit education materials from every accredited university, review them and organize in a complete course that can be then delivered online through an accredited university in the United States with every contributor sharing in the revenue.
FertilityConundrum or another online education delivery platform (accredited university based) can be used as a vehicle to deliver the education.
ACE should also structure and standardize skills training and proficiency verification.
Education has to include training in bedside manners and medical ethics.
This is my presentation at the last ACE meeting during ASRM, which you may also want to review.
3. ACE certification of the embryology practitioners.
Certification requirements have to continuously increase with introduction of more education and training, thereby increasing the watershed between experts and non-experts
ACE certification has to include Doctor of Embryology, which is only reserved for those with doctoral degree meeting a minimum current educational requirements as described in #2.
4. Patients education and marketing.
We need to educate patients about value of an educated embryologist can add to the service they receive at the clinic. Patients need to understand a non-technical, intellectual, component of embryology practice to be able to recognize those practices where they can get the maximum benefit.
As long as ACE certification is not recognized by the government, ACE has to continuously build value for those certified through marketing. Our electronic certificates have proven to be an effective and an inexpensive way to advertize our experts.
6. Involvement into legislations and politics
As much as we don’t want to be involved into anything outside our day jobs, we have no choice but to get engaged into both, politics and legislations to accomplish our goal.
We need to leverage ACE’s philosophical approach to human embryos, that rejects both, treating embryo as a diagnostic specimen or as a human and is calling for recognition of all unique aspects of this stage in human development instead.
It appeals to both sides of political spectrum.
During our efforts of removing embryology from the pending regulation in California, ACE’s position found a strong support among both, pro-life and pro-choice, which are some of the most powerful forces in American politics, often deciding in government and presidential elections.
In conclusion, embryologists in the US and outside of the US are looking at ACE as a last opportunity to return embryology the prestige and significance it once enjoyed.
Please follow this document to see the proposal on embryology consultation: